Citation NR: 9721440
Decision Date: 06/19/97 Archive Date: 06/30/97
DOCKET NO. 95-01 921 ) DATE
)
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On appeal from the
Department of Veterans Affairs Regional Office in Lincoln,
Nebraska
THE ISSUES
1. Entitlement to service connection for bilateral hearing
loss.
2. Entitlement to service connection for tinnitus.
REPRESENTATION
Appellant represented by: The American Legion
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
Nancy S. Kettelle, Counsel
INTRODUCTION
The veteran had active service from January 1966 to October
1966.
This matter comes to the Board of Veterans’ Appeals (Board)
on appeal from a June 1993 rating decision of the Department
of Veterans Affairs (VA) Regional Office (RO) in Lincoln,
Nebraska. The veteran testified before a Hearing Officer at
the RO in March 1994.
The Board also notes that in a September 1994 rating
decision, the RO denied service connection for psychiatric
disability, including post-traumatic stress disorder (PTSD).
In his VA Form 9 received at the RO in December 1994, the
veteran expressed disagreement with this denial. The RO has
not issued a Statement of the Case on this issue so it is not
currently before the Board. It is referred to the RO for
appropriate action.
CONTENTIONS OF APPELLANT ON APPEAL
The veteran contends that he has bilateral hearing loss and
tinnitus as a result of exposure to rifle fire in basic
training and a grenade launch simulator during dog handler
training in service. He states that ear protection was not
provided in service and that he has not been exposed to
acoustic trauma since that time.
DECISION OF THE BOARD
The Board, in accordance with the provisions of 38 U.S.C.A.
§ 7104 (West 1991 & Supp. 1996), has reviewed and considered
all of the evidence and material of record in the veteran's
claims file. Based on its review of the relevant evidence in
this matter, and for the following reasons and bases, it is
the decision of the Board that the evidence supports service
connection for bilateral hearing loss and tinnitus.
FINDINGS OF FACT
The veteran’s bilateral hearing loss and tinnitus were caused
by acoustic trauma in service.
CONCLUSION OF LAW
1. Bilateral hearing loss disability was incurred in
service. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. §§ 3.303,
3.385 (1996).
2. Tinnitus was incurred in service. 38 U.S.C.A. § 1110
(West 1991); 38 C.F.R. § 3.303 (1996).
REASONS AND BASES FOR FINDING AND CONCLUSIONS
Initially, the Board notes that the veteran’s claims are well
grounded within the meaning of 38 U.S.C.A. § 5107(a) (West
1991). That is, the claims are at least plausible. Further,
the Board is satisfied that relevant facts sufficient to
reach an equitable decision have been adequately developed
and that no further assistance to the veteran is required to
comply with 38 U.S.C.A. § 5107(a).
The veteran’s service medical records show that on his
January 1966 report of medical history the veteran responded
yes to the question as to whether he had ever had or then had
ear, nose or throat trouble. The physician commented that
the veteran reported he had had sore throats in childhood.
The January 1966 enlistment examination report shows
audiometer readings in the right ear were 0, 0, 0, 20 and 30
decibels at 500, 1,000, 2,000, 3,000 and 4,000 hertz,
respectively. (Converted to the current 1969 ANSI standard,
those thresholds were 15, 10, 10, 30, and 35 decibels at the
cited frequencies.) Audiometer readings in the left ear were
5, 0, 0, 5 and 10 decibels at the same respective
frequencies. (Converted to the current 1969 ANSI standard,
left ear thresholds were 20, 10, 10, 15 and 15 decibels at
the cited frequencies.) On the examination report, the
physician checked the veteran’s drums as being abnormal but
did not elaborate. Chronological records include no
complaint, finding or diagnosis concerning hearing loss or
tinnitus. At the September 1966 separation examination, the
physician evaluated the veteran’s ear drums as normal.
Audiometer readings in the right ear were -5, -5, 0, 5 and 5
decibels at 500, 1,000, 2,000, 3,000 and 4,000 hertz,
respectively. Left ear audiometer readings were 0, -5, -5, 0
and 0 decibels at the same respective frequencies.
(Converted to the 1969 ANSI standard, right ear thresholds
were 10, 5, 10, 15 and 10 decibels and left ear thresholds
were 15, 5, 5, 10 and 5 decibels at the cited frequencies.)
The veteran’s service records show that his qualification in
arms was for rifle, and he received a marksmanship badge
(rifle). His military occupational specialties were military
policeman and dog handler.
Clinical records from David H. Chait, M.D., an
otolaryngologist, show that in October 1982 the veteran was
seen with complaints of tinnitus in both ears. The veteran
gave a history of hearing loss since age 14. He also
reported the sound of birds in his ears primarily when tired
and depressed. Hearing levels, using the 1969 ANSI standard,
were 0, 0, 30, 65 and 60 decibels in the right ear at 500,
1,000, 2,000, 3,000 and 4,000 hertz, respectively, and left
ear levels at the same respective frequencies were 0, 5, 45,
50 and 45 decibels. The clinical impression after testing
was neurosensory hearing loss and secondary tinnitus.
Clinical records show that in March 1983 the veteran reported
he still had ringing in his ears. He gave a history of
exposure to acoustic trauma and temporary loss of hearing and
tinnitus in service stating that his tinnitus had since
become more bothersome. The audiological impression was
essentially the same as the audiogram in October 1982 showing
a moderate trough-shaped hearing loss, right ear greater than
left ear, from 1,000 hertz to 8,000 hertz.
In a March 1983 letter, Dr. Chait stated that he had seen the
veteran in October 1982 with the complaint of ringing in the
ears which had persisted for a long time and had become more
noticeable in the last several years. Dr. Chait stated that
the veteran gave a significant history of noise trauma dating
back to service. The veteran reported two specific
instances. One was while he was in basic training on the
rifle range when he was observing for eye blinks at the
initiation of rifle fire. The rifle was apparently fired
while the veteran was close to the stock, and he sustained a
temporary loss of hearing and persistent tinnitus. The loss
of hearing lasted for a couple of days and the tinnitus for
sometime after. A second incident occurred while the veteran
was in dog training exercises. A grenade launch simulator
exploded very near the veteran causing him and the dog to be
lifted off the ground. The veteran recalled being unable to
hear for two to three days after this incident and having
intensification of the tinnitus. Dr. Chait stated that
testing demonstrated a significant loss of hearing at the
4,000 hertz range being neurosensory in nature. He also
stated that some loss of discrimination was noted. He
commented that the hearing loss was symmetrical and much more
significant than would be accounted for by age. Dr. Chait
stated that it was his impression that the veteran’s hearing
and subsequent tinnitus probably represented a degree of
noise-induced trauma which by history seemed to be related to
the incidents occurring while in the armed services in the
late 1960s.
At an April 1993 VA audiological evaluation, pure tone
thresholds in the veteran’s right ear were 10, 10, 55, 60 and
65 decibels at 500, 1,000, 2,000, 3,000 and 4,000 hertz,
respectively. In the left ear pure tone thresholds were 5,
10, 55, 50 and 55 hertz at the same respective frequencies.
Speech recognition in the right ear was 96 percent correct
and was 94 percent correct in the left ear. The examiner’s
remarks were moderate to moderately severe sensorineural loss
from 2,000 - 8,000 hertz, right ear, and mild to moderate
sensorineural loss from 2,000 - 4,000 hertz, left ear.
At his March 1994 hearing at the RO, the veteran testified
that in service during dog handler training a grenade
simulator went off so close that it lifted him and his dog
off the ground. He stated that he couldn’t hear anything and
the ringing in his ears was so loud that he could hear
nothing at all. He stated that he may have been seen that
day at the dispensary for dog handlers. The ringing
eventually stopped and he did not seek further treatment
because he did not want to be recycled and lose the
assignment he had been promised. He also testified that
earlier he had been exposed to loud noises in rifle practice
in basic training and during pistol practice in Military
Police School. He testified that he had no ear protection in
service and that since service he had experienced no acoustic
trauma. He stated that he had been unaware of his problem
for many years and Dr. Chait suggested that he had been able
to compensate by watching others carefully when they spoke.
He testified that he had taught in a university college of
business and had had desk jobs where hearing was not of
primary importance.
In a March 1994 statement, a friend of the veteran stated
that he and the veteran had been friends before the veteran
entered service and that in 1967 after the veteran got out of
service he had trouble understanding the dialogue when they
went to the movies. He also stated that when he visited the
veteran some years later the hearing seemed to have gotten
worse.
In a March 1994 statement, a friend of the veteran reported
that he had been a graduate student with the veteran in the
early 1970s and during that time the veteran would complain
of ringing in his ears.
In a March 1994 statement, Dr. Chait stated that the
audiograms for the veteran at entry and exit from service
were inconsistent which suggested they might be inaccurate.
He stated that the veteran’s history showed that the
veteran’s only significant noise trauma was in service,
including an explosion and gun fire. He stated that he had
done a hearing test in 1983 and it showed a significant loss
of hearing and tinnitus, and the loss pattern was typical of
noise trauma. Dr. Chait stated it was quite possible that
the loss occurred during active duty and was not properly
detected at that time , but clearly was evident in 1983.
In an April 1994 statement, the veteran’s ex-wife described
examples of the veteran’s hearing problems from 1970 when she
met him and how they grew progressively worse over time
including complaints of increased ringing and bird chirping
sounds.
Service connection may be established for disability
resulting from personal injury suffered or disease contracted
in the line of duty, or for aggravation of a pre-existing
injury or disease. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303. A
pre-existing injury or disease will be considered to have
been aggravated by active service where there is an increase
in disability during such service, unless there is a specific
finding that the increase in disability is due to the natural
progress of the disease. 38 C.F.R. § 3.306(a) (1996).
Service connection may be granted for any disease diagnosed
after discharge when all the evidence, including that
pertinent to service, establishes that the disease was
incurred in service. 38 C.F.R. § 3.303(d). For the purposes
of applying the laws administered by VA, impaired hearing
will be considered to be a disability when the auditory
threshold in any of the frequencies 500, 1,000, 2,000, 3,000
or 4,000 hertz is 40 decibels or greater, or when the
auditory thresholds for at least three of the frequencies
500, 1,000, 2,000, 3,000 or 4,000 hertz are 26 decibels or
greater, or when speech recognition scores using the Maryland
CNC Test are less than 94 percent. 38 C.F.R. § 3.385.
Results of the April 1993 VA audiological evaluation, with
auditory thresholds greater than 40 decibels at 2,000, 3,000
and 4,000 hertz in each ear, establish that the veteran has
bilateral hearing loss disability for VA purposes and at the
March 1994 hearing the veteran testified that he continued to
suffer from tinnitus. The Board notes that the service
entrance examination audiometer readings show that the
veteran had auditory thresholds greater than 0 decibels at
all pertinent frequencies in both ears. In addition, when
seen by Dr. Chait in October 1982, the veteran gave a history
of hearing loss since age 14. Notwithstanding the veteran
apparently having had some hearing loss when he entered
service, the separation examination report shows the same or
a lower auditory threshold at each frequency in the right ear
and shows a lower auditory threshold at each frequency in the
left ear. Dr. Chait, an otolaryngologist, has noted the
service examination reports and their inconsistency and the
veteran’s history of hearing loss since age 14 and has
nonetheless concluded that the veteran’s post-service
neurosensory hearing loss and tinnitus is probably due to
noise trauma in service. He supports his opinion observing
that the veteran’s hearing loss is much more significant than
would be accounted for by age, the loss is symmetrical and
the loss pattern is typical of noise-induced trauma.
Further, Dr. Chait associates the veteran’s post-service
noise-induced hearing loss and tinnitus with in-service
acoustic trauma described by the veteran, that is, the
acoustic trauma on the rifle firing range and acoustic trauma
with the close explosion of a grenade launch simulator during
dog training exercises. The Board finds the veteran’s
hearing testimony credible as to the occurrence of such
acoustic trauma and his service records, which show he was
awarded a rifle marksmanship badge and completed Military
Police School and was a dog handler, are consistent with such
events. Further, there is no indication that the veteran’s
post-service activities as a graduate student and college
professor have involved exposure to acoustic trauma.
Based on the foregoing, the Board finds that the veteran’s
bilateral hearing loss and tinnitus were caused by acoustic
trauma in service and concludes that service connection is
warranted for those disabilities.
ORDER
Service connection for bilateral hearing loss is granted.
Service connection for bilateral tinnitus is granted.
SHANE A. DURKIN
Member, Board of Veterans' Appeals
38 U.S.C.A. § 7102 (West Supp. 1996) permits a proceeding
instituted before the Board to be assigned to an individual
member of the Board for a determination. This proceeding has
been assigned to an individual member of the Board.
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West
1991 & Supp. 1996), a decision of the Board of Veterans’
Appeals granting less than the complete benefit, or benefits,
sought on appeal is appealable to the United States Court of
Veterans Appeals within 120 days from the date of mailing of
notice of the decision, provided that a Notice of
Disagreement concerning an issue which was before the Board
was filed with the agency of original jurisdiction on or
after November 18, 1988. Veterans’ Judicial Review Act, Pub.
L. No. 100-687, § 402, (CONTINUED ON NEXT PAGE)
102 Stat. 4105, 4122 (1988). The date that appears on the
face of this decision constitutes the date of mailing and the
copy of this decision that you have received is your notice
of the action taken on your appeal by the Board of Veterans’
Appeals.
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